Expertise and Research Interests

The purpose of this five-year longitudinal study is to investigate strategies for improving accessibility, services utilization and retention in treatment for drug dependent pregnant and postpartum women in order to promote maternal health and well-being. It is organized into three levels which correspond to steps in the treatment process. The first level focuses on enrollment of pregnant women in a comprehensive maternal addiction treatment program. The second level addresses retention in treatment, services utilization and improved life outcomes by matching client characteristics and needs to treatment modality when women become active in the program. The third level examines retention in treatment and services utilization for pregnant and postpartum women. These strategies will be examined within the context of the existing model of comprehensive medical and maternal addiction treatment for women at Family Center. The Specific Aims are: 1 to assess the effects of Outreach Tracking of drug dependent pregnant women on enrollment in treatment; 2 to investigate the effects of Client-Treatment Matching for drug dependent pregnant women on retention time in outpatient and residential treatment, services utilization and on life outcomes by matching client characteristics and needs to treatment moclity; 3 to assess the effects of Follow-Up Tracking of drug dependent pregnant and postpartum women on services utilization and retention in treatment. In level one of the study Outreach Tracking will be introduced into the comprehensive treatment model at Family Center to facilitate the participation of pregnant drug dependent women in intake appointments. Randomized assignment to Outreach Tracking and a control group will allow assessment of the effects of this strategy on 288 women's participation in services and retention in treatment. In level two of the study retrospective data from approximately 250 women enrolled at Family Center will be analyzed to develop models of client-treatment matching that predict retention in treatment. These models will then be applied in a prospective study of 288 pregnant and postpartum drug dependent women. Client demographics, health and psychosocial characteristics and needs at intake will be matched to outpatient or residential treatment modalities with an array of services. This matching strategy will be investigated to determine its effects on retention time in treatment and individual maternal outcomes. Clients will be interviewed at three-to six-month intervals over a two-year period of treatment and after care to assess their life outcomes during recovery. In level three of the study community-based Follow-Up Tracking will be added to the comprehensive treatment model in order to increase participation of pregnant and postpartum women who are attending the program less than twice per month. The effects of this strategy on service utilization and retention time in treatment will be examined by means of randomized assignment of women to Follow-Up Tracking and a control group.